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General NPI Number Information
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NPI Number | 1932391448
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Entity Type | Organization
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Legal Business Name | VIJAY K. GUPTA, M.D.
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Dates
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Enumeration Date | 08/17/2007
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Last Update Date | 07/22/2019
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Provider Practice Location Address
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Address Line | 33 CLUB WAY
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City | CEDAR GROVE
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State | NJ
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Zip | 07009-2054
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Country | US
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Telephone | 973-779-1467
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Fax | 973-324-7945
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Provider Business Mailing Address
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Address Line | 285 LEXINGTON AVE
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City | PASSAIC
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State | NJ
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Zip | 07055-6308
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Country | US
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Telephone | 973-779-1467
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Fax | 973-239-4267
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Authorized Official
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Title or Position | OWNER
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Name | DR. VIJAY K GUPTA
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Credential | MD
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Telephone | 973-779-1467
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number |
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License Number State |
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